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Erythrasma and Homoeopathy

©   Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy)

  Dr. Swati Vishnoi B.H.M.S.

  Dr. Preetika Lakhera B.H.M.S.

 For well formatted and illustrated article, please see attached file-

Erythrasma and Homoeopathy.pdf

Contents

Definition. 1

Epidemiology. 1

Predisposing factors. 2

Causes. 2

Physiopathology. 2

Signs and Symptoms. 2

Distribution. 3

Macro distribution. 3

Micro distribution. 3

Types. 3

Primary lesions. 3

Secondary lesions. 3

Diagnosis. 3

Treatment 4

Homoeopathic treatment 4

Bibliography. 6

 

Definition

Erythrasma is a chronic superficial infection (Psora/ Syphilis/ Sycosis) of the intertriginous areas of the skin, caused by Corynebacterium minutissimum, a common commensal in human skin.

Epidemiology

Males and females are equally affected but the crural form is more common in men. It is prevalent in the subtropical and tropical areas than in other parts of the world. It is common in diabetics (Psora/ Syphilis), obese (Psora/ Sycosis) and middle aged women or men.

Predisposing factors

Warm humid climate conditions (Causa occasionalis), diabetes (Psora/ Syphilis), hyperhidrosis (Psora/ Sycosis), obesity (Psora/ Sycosis), poor personal hygiene (Causa occasionalis/ Psora), occlusive clothing (Causa occasionalis), increasing age, and anatomic factors such as tight toe webs (Syphilis) predispose patients to this dermatitis.

Causes

The cause of erythrasma is a bacterial infection and responsible bacteria is Corynebacterium minutissimum. This may coexist with a dermatophyte fungi or with Candida albicans, the common thrush fungus. Erythrasma can be confused with other causes of intertrigo, the rashes in the skin folds. It can infect anyone, but is particularly prevalent in diabetics or persons living in a warm climate.

Physiopathology

This mild superficial infectious disease usually has an insidious onset (Psora) and very mildly symptomatic (Sycosis). Onset is common in adults, rarely children and frequency worsens gradually with increasing age. Corynebacteria, the aerobic bacteria, get collected in the stratum corneum. Living layers of the skin are not affected. Under favorable conditions such as heat and humidity, these organisms proliferate (Psora). The stratum corneum is thickened (Sycosis). The organisms are active in the intercellular spaces as well as within cells, dissolving keratin fibrils (Syphilis). Macules of brown and red discoloration form and gradually coalesce to form large patches that usually stabilize at a maximal size in each affected region. Mature lesions have a dry velvety surface. The typical appearance is a reddish-brown slightly scaly patch with sharp borders.

Signs and Symptoms

The patches of erythrasma occur in damp areas such as the armpits, creases below the breasts, abdominal folds, and perineum. The lesions emerge in wet areas such as the groin, armpit, and skin folds, and may itch slightly. Occasional itching may be accompanied with inflammatory episodes. The main symptoms are reddish-brown, slightly scaly patches with sharp borders. They may itch slightly and often look like patches associated with other fungal infections, such as ringworm.

Erythrasma can be distinguished from ringworm with a Wood's lamp which gives erythrasma, characteristically, a fluoresce of vermeil-red color.

Distribution

Macro distribution

Toe webs, groin, axillae, inframammary creases, vulva and glans penis in decreasing order of frequency.  A rare generalized form can occur on trunk and extremities.

Micro distribution

None

Types

Primary lesions

Primary lesions are sharply marginated red or tan to brown macules.

Secondary lesions

  1. Fine branny gray-white or brown scale gives a dry, velvety appearance
  2. Lichenification in rare pruritic lesions
  3. Post inflammatory hyperpigmentation

Diagnosis

The appearance of erythrasma is often typical. Exposure to longwave ultraviolet radiation, such as with a black light or Wood's light, causes the erythrasma to fluoresce a coral-pink color due to porphyrins released by the bacteria.

The diagnosis can be confirmed by a swab or scraping for microscopy and culture.

 

Treatment

It can be prevented by avoiding excessive heat or moisture and keeping the involved area dry as well as maintaining good hygiene and body weight. Garlic (Allium sativum) is believed to have antibacterial properties and can treat as well as prevent this condition.

Homoeopathic treatment

ERYTHRASMA -  abies-c. abrom-a. abrot. acet-ac. achy. Acon. adam. adon. adren. aesc. aeth. aether Agar. agn. ail. alco. alf. all-s. allox. aloe alum-p. alum-sil. Alum. alumn. am-act. Am-br. AM-C. Am-m. ambr. amph. ANAC. anag. Anan. Ang. Ant-c. Ant-t. anthraci. anthraco. apis apoc. aq-mar. aran-ix. ARAN. arg-met. Arg-n. arist-cl. arist-m. Arn. Ars-br. Ars-i. ars-s-f. ARS. Asaf. asc-c. asim. aspar. aster. atro. aur-ar. aur-m-n. Aur. bac. BAD. bamb-a. bapt. bar-c. bar-i. bar-m. bar-s. Bell. berb. blatta-o. Bor-ac. borx. bov. brid-fr. brom. Brucel. Bry. bufo Calad. calc-act. Calc-ar. calc-caust. calc-f. calc-i. calc-o. Calc-p. Calc-s. calc-sil. CALC. calen. Calo. camph. Canth. CAPS. carb-ac. Carb-an. Carb-v. carbn-s. carc. card-m. Carl. CAUST. cean. Cedr. cephd-i. Cham. chel. chim. chin. chinin-s. Chion. chir-fl. Chlol. chlor. chlorpr. cic. cimic. cina Cist. CLEM. Coc-c. coca cocc. cod. coff. Colch. coloc. Com. Con. cop. cortico. cortiso. Croc. crot-h. Crot-t. cub. cupr-ar. Cupr. cur. cycl. cyna. dig. dros. DULC. Elaps elat. erig. eup-pur. euph. euphr. fago. falco-pe. ferr-i. ferr-m. ferr-p. FERR. fl-ac. flor-p. form. friedr. Fuc. fuli. gal-ac. galeg. gamb. gast. Gels. gink-b. Glon. glyc. glycyr-g. goss. GRAPH. guaj. guare. Gymne. Ham. hed. hell. helon. Hep. hippoc-k. Hura hydrang. hydrog. hygroph-s. Hyos. hyper. Ign. ina-i. indgf-a. ins. Inul. iod. ip. iris Jug-c. Jug-r. kali-act. Kali-ar. Kali-bi. kali-br. KALI-C. kali-chl. Kali-i. kali-m. kali-n. kali-p. Kali-s. kali-sil. kalm. ketogl-ac. kiss. kola KREOS. Lac-ac. lac-c. Lac-d. lac-e. lac-h. Lach. lat-m. lath. laur. Led. Lem-m. lept. lipp. lith-c. lob-e. lob. Lyc. lycpr. lycps-v. lyss. m-ambo. m-arct. m-aust. mag-act. Mag-c. mag-m. mag-o. Mag-p. mag-s. magn-gr. mang-act. Mang. med. meli. meny. merc-d. merc-i-f. Merc. MEZ. moni. morg-p. morg. morind-l. morind-m. morph. mosch. mur-ac. murx. myos-a. Naja narc-ps. Nat-act. Nat-ar. Nat-c. nat-ch. nat-f. NAT-HCHLS. nat-lac. NAT-M. nat-p. NAT-S. nauc-l. nep. NIT-AC. NUX-M. NUX-V. oci-sa. Olnd. onop. OP. orthos-s. oscilloc. ox-ac. oxyg. ozone paeon. pancr. Par. peps. perh. pert-vc. Petr. ph-ac. Phase. phlor. phos. PHYT. pic-ac. pilo. pitu-a. pitu-gl. pix plac-s. plan. plat. plb. pneu. podo. positr. pot-e. PSOR. PULS. rad-br. rad-met. Ran-b. ran-s. rat. rauw. rheum RHOD. Rhus-a. rhus-r. RHUS-T. rumx. Ruta sabad. sabal sabin. sacch-a. sacch-l. sacch. sal-ac. sang. sanic. sarcol-ac. saroth. Sars. Sel. senec. seneg. SEP. Ser-ang. SIL. sin-n. spig. spong. Squil. stann. STAPH. stict. still. Stram. strept-ent. streptoc. Stront-c. stroph-h. stry-ar. sul-ac. sul-i. sulfonam. SULPH. sumb. syc. syph. SYZYG. tab. tarax. tarent. TER. Terebe. term-a. teucr. Thuj. Thyr. Thyroiod. til. tritic-vg. tub-m. Tub. tung-met. tus-fr. uran-m. Uran-n. Urea Vac. valer. vanad. vanil. Verat. verb. vero-o. vichy-g. vinc-r. vinc. vince. viol-o. Viol-t. vip. zinc-p. Zinc. zing.

GENERALS - DIABETES MELLITUS - accompanied by – eczema ins.

GENERALS - DIABETES MELLITUS abrom-a. acet-ac. adren. aether alf. all-s. allox. aloe alumn. am-act. anthraco. apoc. arg-met. arg-n. arist-m. Ars-br. ars. asc-c. aspar. aur-m-n. aur. bar-m. Bor-ac. bov. brid-fr. calc-p. calc-sil. calc. canth. carb-ac. carb-v. carc. card-m. Carl. caust. cean. cephd-i. chel. chim. Chion. chlol. chlorpr. clem. coca cod. coff. coloc. con. cop. cortico. cortiso. cub. cupr-ar. cupr. cur. eup-pur. ferr-i. ferr-m. ferr-p. fl-ac. flor-p. friedr. gal-ac. galeg. glyc. Gymne. hed. helon. hydrang. hygroph-s. indgf-a. ins. Inul. iod. iris kali-act. kali-br. kali-chl. kali-i. kali-p. kiss. kreos. Lac-ac. lac-d. lach. led. lept. lith-c. lyc. lycps-v. mag-act. mag-o. mag-p. mag-s. mang-act. med. meny. merc-d. merc. moni. morind-l. morind-m. morph. mosch. mur-ac. murx. nat-ch. nat-lac. nat-m. nat-p. NAT-S. nauc-l. nep. nit-ac. nux-v. Op. orthos-s. oxyg. pancr. peps. perh. ph-ac. Phase. phlor. phos. pic-ac. pilo. plan. plb. podo. rad-br. rad-met. ran-b. rat. Rhus-a. rhus-r. rhus-t. sacch-l. sal-ac. sanic. sarcol-ac. saroth. sep. Ser-ang. sil. spong. Squil. stict. stront-c. stry-ar. sul-ac. sulfonam. sulph. syph. SYZYG. tarent. TER. Terebe. term-a. thuj. thyr. uran-m. Uran-n. Urea vanad. vichy-g. vinc-r. vince.

GENERALS – OBESITY Acon. adam. adon. agar. ail. alco. all-s. Am-br. Am-c. Am-m. ambr. ANAC. Ang. Ant-c. ant-t. apis aq-mar. aran-ix. arist-cl. arn. Ars. Asaf. Aur. bac. bar-c. Bell. berb. blatta-o. borx. brom. bry. bufo calad. calc-act. Calc-ar. calc-caust. calc-o. Calc-p. calc-s. CALC. Calo. camph. canth. CAPS. carb-v. carc. Carl. caust. cham. chin. chlorpr. cic. cimic. clem. Coc-c. coca cocc. coloc. con. cortiso. Croc. crot-h. Cupr. cyna. dig. dulc. Elaps euph. euphr. falco-pe. ferr-i. FERR. Fuc. gamb. gink-b. glycyr-g. GRAPH. guaj. hell. Hura Hyos. ign. iod. ip. Kali-bi. kali-br. Kali-c. kola lac-c. Lac-d. lac-h. lach. laur. lith-c. lob-e. lob. Lyc. lycpr. mag-c. mag-p. mang-act. med. merc-d. merc. mur-ac. nat-ar. nat-c. NAT-M. nux-m. nux-v. olnd. op. ozone pert-vc. Phos. PHYT. pitu-a. plat. plb. positr. Puls. rauw. rheum rhus-t. rumx. ruta sabad. sabal sacch. sars. sel. seneg. sep. sil. spig. spong. staph. stram. stront-c. stroph-h. Sulph. thuj. Thyr. Thyroiod. tus-fr. valer. vanil. verat. viol-o.

GENERALS - VAULTS, cellars agg. ant-t. aran. ARS. atro. Bry. calc. Carb-an. carc. card-m. caust. dulc. form. Kali-c. lyc. merc-i-f. NAT-S. PULS. RHUS-T. Sel. Sep. Stram. ter.

GENERALS - WEATHER - wet weather - agg. abies-c. abrot. achy. aesc. agar. aloe alum-sil. AM-C. amph. anac. ant-c. Ant-t. ARAN. arg-met. Arg-n. Ars-i. ars-s-f. ARS. aster. aur-ar. aur. BAD. bapt. bar-c. bar-i. bar-m. bar-s. bell. blatta-o. borx. bov. brom. Brucel. bry. calc-f. calc-i. Calc-p. Calc-s. calc-sil. CALC. calen. canth. carb-an. Carb-v. carbn-s. caust. Cedr. cham. chim. chin. chinin-s. Cimic. Cist. clem. Colch. con. crot-h. cupr. cur. DULC. elaps elat. erig. euphr. Ferr. form. Gels. Glon. Graph. Ham. Hep. hydrog. hyper. Iod. ip. kali-bi. kali-c. Kali-i. kali-m. kali-n. kali-sil. Lac-ac. lac-d. Lach. lath. laur. Lem-m. Lyc. lyss. mag-c. Mag-p. magn-gr. Mang. med. meli. Merc. mez. mur-ac. Naja Nat-act. Nat-c. NAT-HCHLS. nat-m. NAT-S. Nit-ac. NUX-M. nux-v. oci-sa. olnd. onop. op. oscilloc. paeon. petr. phos. Phyt. pic-ac. pneu. psor. PULS. rad-br. Ran-b. rauw. RHOD. RHUS-T. Ruta sang. sars. senec. seneg. Sep. Sil. sin-n. spig. stann. staph. stict. still. strept-ent. streptoc. Stront-c. sul-ac. sul-i. Sulph. sumb. syc. syph. teucr. Thuj. Tub. tung-met. vac. Verat. zinc-p. Zinc. zing.

SKIN - ERUPTIONS - Bend of joints cupr. graph. kreos. nat-m. psor. sep.

SKIN - ERUPTIONS – brownish anag. dulc. nit-ac. ph-ac. phos. puls. syph. tritic-vg.

SKIN - ERUPTIONS - Folds of skin; in Ars. calc. carb-v. graph. hep. lyc. merc. Nat-m. Petr. PSOR. puls. sel. sep. sil. sulph.

SKIN - ERUPTIONS – inflamed am-c. ars. calc. dulc. led. Lyc. ruta tritic-vg.

SKIN - ERUPTIONS – itching acon. aeth. Agar. agn. allox. alum-p. alum-sil. Alum. Am-c. am-m. ambr. Anac. anag. Ant-c. Ant-t. anthraci. Apis arg-met. Arn. Ars-i. ars-s-f. ARS. asaf. aur-m-n. bamb-a. bar-c. bar-s. bell. borx. bov. Bry. bufo Calad. Calc-p. Calc-s. calc-sil. Calc. Canth. caps. carb-an. carb-v. carbn-s. carl. CAUST. Cham. chel. chinin-s. cic. cimic. cina CLEM. cocc. cod. colch. Com. con. Cop. cortiso. Crot-t. cupr. dig. dros. dulc. fago. ferr. fl-ac. fuli. gast. gink-b. goss. GRAPH. guaj. guare. Hep. hippoc-k. Ign. iod. ip. iris Jug-c. Jug-r. Kali-ar. kali-bi. kali-br. Kali-c. Kali-i. kali-n. kali-p. Kali-s. kali-sil. kalm. Kreos. lac-d. lac-e. Lach. lat-m. laur. Led. Lyc. m-ambo. m-arct. m-aust. mag-c. mag-m. mang. Merc. MEZ. morg-p. morg. myos-a. nat-ar. nat-c. nat-f. NAT-M. NIT-AC. NUX-V. Olnd. ox-ac. Par. Petr. ph-ac. Phos. Phyt. pic-ac. pitu-gl. pix plac-s. plb. positr. pot-e. Psor. Puls. Ran-b. ran-s. RHUS-T. ruta sabad. sabin. sacch-a. Sars. Sel. SEP. Sil. spig. spong. Squil. stann. STAPH. stram. stront-c. sul-ac. SULPH. tarax. tarent. teucr. thuj. til. tritic-vg. tub-m. Vac. valer. verat. vero-o. vinc. Viol-t. zinc-p. zinc.

SKIN - ERUPTIONS - perspiration; during Apis ars. bry. calc. Con. ip. lyc. nat-m. OP. puls. RHUS-T. SEP. sulph. Thuj.

SKIN - ERUPTIONS - red – Areola anac. ant-c. ant-t. borx. cocc. dulc. tab.

SKIN - ERUPTIONS – red acon. Agar. AM-C. anac. Anan. ant-c. ant-t. apis Arn. Ars. asim. aur-ar. aur. bell. berb. bry. calad. Calc. caust. cham. chel. chinin-s. chir-fl. Chlol. cic. cina Clem. cocc. Com. con. cop. crot-t. cycl. Dulc. fl-ac. goss. Graph. ina-i. Kali-bi. KALI-C. kali-s. ketogl-ac. lach. Led. lipp. lyc. m-ambo. Mag-c. MERC. Mez. Nit-ac. op. ox-ac. petr. ph-ac. PHOS. plb. psor. ran-b. Rhus-t. sabad. sars. sep. sil. spig. squil. staph. Stram. SUL-AC. SULPH. tab. thuj. til. tritic-vg. tub. valer. vanil. verat. verb. vero-o. vip.

SKIN - ERUPTIONS - scaly - bran-like agar. alum. am-c. anac. arg-met. ars-i. ars-s-f. ARS. aur-ar. aur. borx. bry. bufo calc-p. CALC. canth. carb-ac. carb-an. carb-v. chlor. Cic. clem. Dulc. graph. iod. Kali-ar. KALI-CHL. kali-i. kali-m. KREOS. lach. led. Lyc. mag-c. mang. merc. mez. Nat-ar. nat-m. Nit-ac. olnd. petr. phos. PHYT. rad-br. ran-b. rhus-t. sanic. Sep. SIL. staph. sulph. Thuj. thyr. tub.

SKIN - ERUPTIONS - slow evolution in eruptive diseases ail.

SKIN - ERUPTIONS - weather agg.; wet narc-ps.

SKIN - ERUPTIONS - wet agg.; getting arist-cl.

Bibliography

Wood’s Light" height="48" width="37"> Approach to the Patient with a Skin Disorder > Wood’s Light Harrison's Principles of Internal Medicine..., a Wood’s lamp will cause erythrasma (a superficial, intertriginous infection caused by Corynebacterium minutissimum ) to show a characteristic coral pink color, and wounds colonized by Pseudomonas will appear pale blue. Tinea capitis caused by certain dermatophytes (e.g., Microsporum canis or M...

Erythrasma" height="48" width="32"> Bacterial Colonizations and Infections of Skin and Soft Tissues > Erythrasma Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e

Clinical Manifestation" height="48" width="32"> Bacterial Colonizations and Infections of Skin and Soft Tissues > Clinical Manifestation Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e ... Figure 25-1. Erythrasma: axilla Sharply marginated, red patch in the axilla. Wood's lamp demonstrates bright coral-red, differentiating erythrasma from intertriginous psoriasis. KOH preparation was negative for hyphae. Figure 25-2. Erythrasma: webspace This macerated...

Clinical Features" height="48" width="36"> Chapter 119. Erythrasma > Clinical Features The Color Atlas of Family Medicine, 2e ... Figure 119-3 Light brown erythrasma in the groin of a young man. It does not have the degree of scaling usually seen with tinea cruris. ( Courtesy of Dan Stulberg, MD .) Figure 119-4 Brown erythrasma in the groin of a man with diabetes. ( Courtesy of the University of Texas Health...

Differential Diagnosis" height="48" width="36"> Chapter 119. Erythrasma > Differential Diagnosis The Color Atlas of Family Medicine, 2e ... Psoriasis—Inverse psoriasis occurs in the same areas as erythrasma and also causes pink to red plaques with well-demarcated borders. The best way to distinguish psoriasis from erythrasma is to look for other clues of psoriasis in the patient, including nail pitting or onycholysis...

Epidemiology" height="48" width="36"> Chapter 119. Erythrasma > Epidemiology The Color Atlas of Family Medicine, 2e ... The incidence of erythrasma is approximately 4%. 1 Both sexes are equally affected. The inguinal location is more common in men. ...

Etiology and Pathophysiology" height="48" width="36"> Chapter 119. Erythrasma > Etiology and Pathophysiology The Color Atlas of Family Medicine, 2e ... Figure 119-2 Coral red fluorescence seen with a Wood lamp held in the axilla of a patient with erythrasma. ( Courtesy of the University of Texas Health Sciences Center, Division of Dermatology .) Corynebacterium minutissimum , a lipophilic Gram-positive non-spore-forming rod-shaped...

Patient Education" height="48" width="36"> Chapter 119. Erythrasma > Patient Education The Color Atlas of Family Medicine, 2e ... Reassure the patient that erythrasma is curable with antibiotic treatment. ...

Typical Distribution" height="48" width="36"> Chapter 119. Erythrasma > Typical Distribution The Color Atlas of Family Medicine, 2e ... Erythrasma is characteristically found in the intertriginous areas, especially the axilla and the groin. Patches of erythrasma may also be found in the interspaces of the toes, intergluteal cleft, perianal skin, and inframammary area. ...

Erythrasma" height="48" width="36"> Chapter 119. Erythrasma The Color Atlas of Family Medicine, 2e

Erythrasma" height="48" width="36"> Chapter 176. Superficial Cutaneous Infections and Pyodermas > Erythrasma Fitzpatrick's Dermatology in General Medicine, 8e ... Erythrasma is a common superficial bacterial infection of the skin characterized by well-defined but irregular reddish-brown patches, occurring in the intertriginous areas, or by fissuring and white maceration in the toe clefts. It is commonly misdiagnosed as tinea cruris for many months before...

Etiology and Epidemiology" height="48" width="36"> Chapter 176. Superficial Cutaneous Infections and Pyodermas > Etiology and Epidemiology Fitzpatrick's Dermatology in General Medicine, 8e ... Corynebacterium minutissimum , the etiologic agent of erythrasma, is a short, Gram-positive rod with subterminal granules. The infection is more common in tropical than in temperate climates. In a study in a temperate climate, 20% of randomly selected subjects were found to have erythrasma...

Differential Diagnosis" height="48" width="34"> Dermatologic Disorders > Differential Diagnosis Current Medical Diagnosis & Treatment 2016 ... of K Zipperstein.) eFigure 6–46. Erythrasma presenting in the axillary fold. (Courtesy of K Zipperstein.) eFigure 6–47. A diagnostic feature of erythrasma is the coral-red fluorescence observed here in focal distribution under a Wood light. (Courtesy of K Zipperstein...

C. minutissimum (Erythrasma)" height="48" width="37"> Diphtheria and Other Corynebacterial Infections > C. minutissimum (Erythrasma) Harrison's Principles of Internal Medicine ... Erythrasma is a cutaneous infection producing reddish-brown, macular, scaly, pruritic intertriginous patches. The dermatologic presentation under the Wood’s lamp is of coral red fluorescence. C. minutissimum appears to be a common cause of erythrasma, although there is evidence...

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